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Conference Paper: “Skipped” level disc degeneration of the lumbar spine, a MRI study of 1989 individuals

Title“Skipped” level disc degeneration of the lumbar spine, a MRI study of 1989 individuals
Authors
Issue Date2010
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
The 2010 Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), Auckland, New Zealand, 13-17 April 2010. In Spine, Affiliated Society Meeting Abstracts: Oct 2010, p. 224 How to Cite?
AbstractINTRODUCTION: This study describes prevalence and risk factors associated with an unusual pattern of disc degeneration of the lumbar spine which we term “skipped” level disc degeneration (SLDD), in which levels of degenerated discs have intervening non‐degenerated level(s). METHODS: As part of a large population‐based genetic study in Southern Chinese (N=1,989), subjects had MRI assessments of the whole lumbar spine. Disc degeneration of more than two levels (n=838) were grouped into SLDD (n=174) and non‐SLDD (contiguous, multilevel; n=664). Additional radiographic abnormalities and subject demographics were also assessed. RESULTS: SLDD was present in 8.7% of the population, and 20.8% of subjects with multilevel disc degeneration (n=838). SLDD was more prevalent in males (adjusted OR: 1.48; 95% CI: 1.04 to 2.10; p=0.028), and was significantly associated with the presence of Schmorl’s nodes (adjusted OR: 2.72; 95% CI: 1.78 to 4.15; p<0.001). A number of patterns of “skipped” can be identified in which there could be more than one level of intervening non‐degenerated discs, or multiple levels of degeneration above and below the non‐degenerated level. Disc bulge/extrusion and back injury history were significantly associated with non‐SLDD (p<0.05), as was back pain. A greater degree of overall disc degeneration severity was associated with non‐SLDD. Other demographics and MRI findings did not significantly differ between groups (p>0.05). CONCLUSIONS: To our knowledge, this is the first study to describe the prevalence and factors associated with SLDD. Our study challenges the “traditional” paradigm for the development of disc degeneration. Although age and biomechanical factors may play a role, the presence of skipped levels would suggest non‐mechanical factors or altered mechanics of the lumbar spine plays a role in the development of disc degeneration. Such factors warrant further investigation and may shed light into the cause and mechanism of disc degeneration.
DescriptionGeneral Posters: GP82
Persistent Identifierhttp://hdl.handle.net/10722/126506
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459

 

DC FieldValueLanguage
dc.contributor.authorCheung, KMCen_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorKarppinen, Jen_HK
dc.contributor.authorMok, FPSen_HK
dc.contributor.authorHo, DWHen_HK
dc.contributor.authorFong, DYTen_HK
dc.contributor.authorLuk, KDK-
dc.date.accessioned2010-10-31T12:32:39Z-
dc.date.available2010-10-31T12:32:39Z-
dc.date.issued2010en_HK
dc.identifier.citationThe 2010 Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), Auckland, New Zealand, 13-17 April 2010. In Spine, Affiliated Society Meeting Abstracts: Oct 2010, p. 224en_HK
dc.identifier.issn0362-2436-
dc.identifier.urihttp://hdl.handle.net/10722/126506-
dc.descriptionGeneral Posters: GP82-
dc.description.abstractINTRODUCTION: This study describes prevalence and risk factors associated with an unusual pattern of disc degeneration of the lumbar spine which we term “skipped” level disc degeneration (SLDD), in which levels of degenerated discs have intervening non‐degenerated level(s). METHODS: As part of a large population‐based genetic study in Southern Chinese (N=1,989), subjects had MRI assessments of the whole lumbar spine. Disc degeneration of more than two levels (n=838) were grouped into SLDD (n=174) and non‐SLDD (contiguous, multilevel; n=664). Additional radiographic abnormalities and subject demographics were also assessed. RESULTS: SLDD was present in 8.7% of the population, and 20.8% of subjects with multilevel disc degeneration (n=838). SLDD was more prevalent in males (adjusted OR: 1.48; 95% CI: 1.04 to 2.10; p=0.028), and was significantly associated with the presence of Schmorl’s nodes (adjusted OR: 2.72; 95% CI: 1.78 to 4.15; p<0.001). A number of patterns of “skipped” can be identified in which there could be more than one level of intervening non‐degenerated discs, or multiple levels of degeneration above and below the non‐degenerated level. Disc bulge/extrusion and back injury history were significantly associated with non‐SLDD (p<0.05), as was back pain. A greater degree of overall disc degeneration severity was associated with non‐SLDD. Other demographics and MRI findings did not significantly differ between groups (p>0.05). CONCLUSIONS: To our knowledge, this is the first study to describe the prevalence and factors associated with SLDD. Our study challenges the “traditional” paradigm for the development of disc degeneration. Although age and biomechanical factors may play a role, the presence of skipped levels would suggest non‐mechanical factors or altered mechanics of the lumbar spine plays a role in the development of disc degeneration. Such factors warrant further investigation and may shed light into the cause and mechanism of disc degeneration.-
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com-
dc.relation.ispartofSpine-
dc.title“Skipped” level disc degeneration of the lumbar spine, a MRI study of 1989 individualsen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailCheung, KMC: cheungmc@hku.hken_HK
dc.identifier.emailSamartzis, D: dsamartzis@msn.comen_HK
dc.identifier.emailMok, FPS: fpsmok@hku.hken_HK
dc.identifier.emailHo, DWH: dwhho@hku.hken_HK
dc.identifier.emailFong, DYT: dytfong@hku.hk-
dc.identifier.emailLuk, KDK: hrmoldk@hkucc.hku.hk-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros173013en_HK
dc.identifier.hkuros180340-
dc.identifier.volumeAffiliated Society Meeting Abstracts: Oct 2010-
dc.identifier.spage224-
dc.identifier.epage224-
dc.publisher.placeUnited States-
dc.description.otherThe 2010 Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), Auckland, New Zealand, 13-17 April 2010. In Spine, Affiliated Society Meeting Abstracts: Oct 2010, p. 224-

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